Pattern of Deaths among Women of Reproductive Age in Major Autopsy Centres of Capital Cities of the Seven Provinces of Nepal.

BACKGROUND: The females in the reproductive age group are vulnerable to injuries and diseases. There is no reliable evidence of the pattern of deaths in reproductive age group females from Nepal. This study was conducted to explore the patterns of deaths of females of the reproductive age group in Nepal. METHODS: A multicentric quantitative cross-sectional study was conducted among the 611 deceased females of age 15 to 49 years who had undergone medico-legal autopsy in major autopsy centers of the capital cities of seven provinces of Nepal in a duration of one year. The demographic, clinical, and causes of death data were retrieved from the records and analyzed. The intentional and unintentional causes were compared with the marital status, age groups, ethnicity, and deceased of rural and urban communities. RESULTS: Female reproductive age group deaths constituted 611 (20·64%) of the total autopsies. Suicide was the most common manner of death (413, 67·59%) followed by accident (121, 19·80%). The most common cause of suicide was hanging (258, 62·47%) followed by poisoning (149, 36·08%) whereas road traffic accident (72, 59·5%) was the commonest cause of accidental death. Intentional deaths were associated with higher risk to the females of younger age groups (p<0·001), ethnicity of the hilly region (p<0·001), and unmarried women (p=0·001). CONCLUSIONS: Suicide was the commonest manner of death among the autopsies of females of the reproductive age group in Nepal. Appropriate preventive strategies need to be developed to uplift the overall health, socioeconomic status, and general wellbeing of the females.

Abnormal Chest Computed Tomography Findings among Admitted Symptomatic COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: COVID-19 has emerged as a pandemic and has varied clinical presentation. Computed Tomography scans of the chest play an important role in evaluating the lung parenchymal changes and aids in better planning the management of COVID-19 patients. The purpose of this study was to find the prevalence of abnormal chest computed tomography findings among admitted symptomatic COVID-19 patients in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted from 25 October 2020 to January 2021 in a tertiary care hospital. Ethical approval was taken from the Institutional Review Committee (Registration number: 348). Convenience sampling method was used. Chest computed tomography findings of the admitted symptomatic COVID-19 patients were evaluated for abnormal findings. Point estimate and 95% Confidence Interval were calculated. Results: Among 153 patients, abnormal chest computed tomography findings were seen in 147 (96.07%) (92.99-99.15, 95% Confidence Interval). The findings of ground-glass opacities with consolidations were seen in 78 (53.06%) patients. Conclusions: The prevalence of abnormal chest findings among symptomatic COVID-19 patients in our study was similar to the studies done in other countries in similar settings. Majority of the symptomatic COVID-19 patients showed abnormal chest computed tomography scan findings in the form of ground glass opacities and consolidations. Keywords: COVID-19; Nepal; pneumonia; prevalence.

Unusual Presentation of Extruded Disc: A Case Report.

A 38-year male presented with severe low back pain radiating towards right lower limb which was progressively increasing with decrease in motor power of the ipsilateral ankle dorsiflexion and toe extension. Magnetic Resonance study with gadolinium suggested dorsal epidural migration of the extruded disc at L4-L5 level compressing the thecal sac, which mimics the differential diagnosis epidural abscess, epidural hematoma, synovial cyst and extradural space-occupying lesion. Open lumbar discectomy was done, and the large, herniated disc was found dorsal to the thecal sac adhering dura mater, which was removed meticulously and the patient was symptomatically better postoperatively. The power of his lower limb gradually increased by physiotherapy in subsequent follow-up.